舌下含服硝酸甘油对冠状动脉CT成像质量影响的研究

The Research About Holding Nitroglycerin Under the Tongue Influenced the Image Quality of Coronary Angiography with 16-slice Spiral CT

目的探讨舌下含服硝酸甘油对16层螺旋CT冠状动脉成像质量的影响。资料与方法对22例临床怀疑冠心病的患者行16层螺旋CT冠状动脉成像,随机分为A(不含服硝酸甘油,11例)、B(含服硝酸甘油,11例)两组。依据美国心脏病协会冠状动脉分段标准,A组观察133个节段,B组观察142个节段。分别测量每一血管段内径,并对每一血管段进行曲面重建(CPR)、多平面重建(MPR),对其图像质量进行评级。结果(1)B组较A组各血管段内径均有增宽趋势;(2)A组图像质量评级为“优良”的血管段91个(91/133),B组为122个(122/142);A组图像质量评级为“差”的血管段42个(42/133),B组为20个(20/142)。B组与A组图像质量差异有统计学意义(P<0.01)。结论检查前患者舌下含服硝酸甘油可以提高冠状动脉CT成像质量。

Objective To evaluate the image quality after holding nitroglycerin under the tongue with 16-slice spiral CT coronary angiography （CTCA）. Materials and Methods 22 cases suspected with coronary disease （CHD） were performed with CTCA, they were randomly assigned into two groups： Group A （not holding nitroglycerin under the tongue）, Group B （holding nitroglycerin under the tongue）. According to coronary segment standard of Amerian Heart Association, there were respectively 133 segments, 142 segments in Group A and B respectively. Diameter of each artery segment was measured and reconstructed by CPR and MPR, image quality was graded. Results There was a increased tendency about segment diameter in Group B compared with Group A. The ＂Excellent＂ segments were 91（91/133） in Group A, 122（122/142） in Group B respectively. The ＂Worse＂ segments were 42（42/133） in Group A, 20（20/142） in Group B respectively. The difference was obvious between two groups （ P 〈 0.01 ）. Conclusion High image quality of CTCA can be obtained after holding nitroglycerin under the tongue.